Informed Consent and Controlled Substance Agreement for Treatment of Chronic PainConsent and Controlled Substance Agreement • March 26th, 2020
The purpose of this agreement is to provide information to the patient regarding the use of controlled substances (opioid medications) for the treatment of chronic pain and to advise the patient of Valley Pain Consultants’ expectations and requirements concerning prescriptions of controlled substances for their patients. The goal of any therapy is to assist the patient in achieving the best possible quality of life given the reality of the clinical condition being treated. Prescriptions of controlled substances may be part of the overall treatment plan in order to reduce pain and increase functional capacity.
INFORMED CONSENT AND CONTROLLED SUBSTANCE AGREEMENTConsent and Controlled Substance Agreement • April 14th, 2024
TO THE PATIENT: As a patient, you have the right to be informed about your condition and the recommended medical or diagnostic procedure or drug therapy to be used, so that you may make the informed decision whether or not to take the drug after knowing the risks and hazards involved. This disclosure is not meant to scare or alarm you, but rather it is an effort to make you better informed so as your physician. For the purpose of this agreement the use of the word “physician” is defined to include not only my physician, but also my physician’s authorized associates, technical assistants, nurses, staff, and other health care providers as might be necessary or advisable to treat my condition.
INFORMED CONSENT AND CONTROLLED SUBSTANCE AGREEMENTConsent and Controlled Substance Agreement • March 21st, 2021
TO THE PATIENT: As a patient, you have the right to be informed about your condition and the recommended medical or diagnostic procedure or drug therapy to be used, so that you may make the informed decision whether or not to take the drug after knowing the risks and hazards involved. This disclosure is not meant to scare or alarm you, but rather it is an effort to make you better informed so as your physician. For the purpose of this agreement the use of the word “physician” is defined to include not only my physician, but also my physician’s authorized associates, technical assistants, nurses, staff, and other health care providers as might be necessary or advisable to treat my condition.
Informed Consent and Controlled Substance Agreement for Treatment of Chronic PainConsent and Controlled Substance Agreement • April 13th, 2022
The purpose of this agreement is to provide information to the patient regarding the use of controlled substances (opioid medications) for the treatment of chronic pain and to advise the patient of your healthcare provider Consultants’ expectations and requirements concerning prescriptions of controlled substances for their patients. The goal of any therapy is to assist the patient in achieving the best possible quality of life given the reality of the clinical condition being treated. Prescriptions of controlled substances may be part of the overall treatment plan in order to reduce pain and increase functional capacity.
INFORMED CONSENT AND CONTROLLED SUBSTANCE AGREEMENTConsent and Controlled Substance Agreement • March 21st, 2021
TO THE PATIENT: As a patient, you have the right to be informed about your condition and the recommended medical or diagnostic procedure or drug therapy to be used, so that you may make the informed decision whether or not to take the drug after knowing the risks and hazards involved. This disclosure is not meant to scare or alarm you, but rather it is an effort to make you better informed so as your physician. For the purpose of this agreement the use of the word “physician” is defined to include not only my physician, but also my physician’s authorized associates, technical assistants, nurses, staff, and other health care providers as might be necessary or advisable to treat my condition.
